National Survey of Thai Infectious Disease Physicians on Treatment of Carbapenem-ResistantAcinetobacter baumanniiVentilator-Associated Pneumonia: The Role of Infection Control Awareness

Abstract

OBJECTIVETo evaluate the expected and treatment outcomes of Thai infectious disease physicians (IDPs) regarding carbapenem-resistantAcinetobacter baumannii(CRAB) ventilator-associated pneumonia (VAP)METHODSFrom June 1, 2014, to March 1, 2015, survey data regarding the expected and clinical success rates of CRAB VAP treatment were collected from all Thai IDPs. The expected success rate was defined as the expectation of clinical response after CRAB VAP treatment for the given case scenario. Clinical success rate was defined as the overall reported success rate of CRAB VAP treatment based on the clinical practice of each IDP. The expected and clinical success rates were divided into low (<60%), standard (60%–80%), and high (>80%) categories and were then compared with standard clinical response rates archived in the existing literature.RESULTSOf 183 total Thai IDPs, 111 (60%) were enrolled in this study. The median expected and clinical success rates were 68% and 58%, respectively. Using multivariate analysis, we determined that working in a hospital that implemented the standard intervention combined with an intensified infection control (IC) intervention for CRAB (adjusted odds ratio [aOR], 3.01; 95% confidence interval [CI], 1.17–7.73;P=.02) was associated with standard and high expected rates (>60%). Being a board-certified IDP (aOR, 5.76; 95% CI, 2.16–15.37;P<.01) and having higher number of ID consultation cases per month (aOR, 4.84; 95% CI, 1.98–11.80;P<.01) were associated with standard and high clinical success rates (>60%). We identified a significant correlation between expected and clinical success rates (r=0.58;P<.001).CONCLUSIONSAwareness of IC among IDPs can improve physicians’ expected and clinical success rates for CRAB VAP treatment, and treatment experience impacts overall treatment success.Infect. Control Hosp. Epidemiol.2015;37(1):61–69